Constant critical comment from politicians and media commentators chips away at nurses’ confidence and optimism about their roles, says Josie Irwin
Preliminary findings from this year’s Royal College of Nursing employment survey show that 93% of nursing staff in the NHS usually work in excess of their contracted hours and, for half of these people, these extra hours are unpaid. For 20%, this means working extra hours on every shift. Of the respondents, 83% reported their individual workload had increased over the last 12 months, and 61% were too busy to provide the level of care they would like to offer.
These findings reinforce the conclusions of the RCN 2012 survey Beyond Breaking Point? This looked at members’ health, wellbeing and stress, and revealed a nursing workforce struggling with increased workloads and work pace, while feeling unsupported and detached from changes being implemented in the workplace. Respondents reported working long hours, unrealistic time pressures and unachievable deadlines.
“While pay has never been the primary consideration for nurses, once they start to feel that pay is unfair, morale is strongly affected”
Poor working environments, where morale is low, damage the ability of nursing staff to provide safe and compassionate care. At the end of June, the chancellor George Osborne announced further pay restraint for public sector staff, including NHS pay being held at 1% in 2015-16. This follows a 1% pay rise for this and next year, and a pay freeze in the period 2011-2013.
He also set out reforms to automatic progression, telling MPs: “Progression pay can, at best, be described as antiquated; at worst, it’s deeply unfair to other parts of the public sector who don’t get it, and to the private sector who have to pay for it.”
While he went on to make it clear that his targets for removing automatic increments are civil servants, teachers, prison officers and the police, his inference that public sector staff more broadly receive increments for “time served” and do not earn them is contributing to nurses feeling unvalued and demotivated. While pay has never been the primary consideration for nurses, once they start to feel that pay is unfair, morale is strongly affected.
Nursing staff are anxious about pay - both now and for the future. There continues to be noise in the NHS human resources community about further reductions in pay, terms and conditions. And the Foundation Trust Network has said the changes implemented from April 2013 to link pay progression with performance do not go far enough.
Inaccurate and unfair comparisons with the private sector and constant inferences that NHS staff are not performing sap morale; this may already be impacting on recruitment and retention. This year, we have seen a rise in NHS trusts recruiting abroad - particularly from Spain and Portugal - increases in spending on agency nursing staff and evidence of difficulty filling shifts in specialties such as critical care.
Of course, other factors are influencing the nursing labour market - the supply of new registered nurses has been affected by cuts to training places and demand has risen because the recession has taken a toll on health. However, constant critical comment from leading politicians and media commentators is bound to chip away at nurses’ confidence and optimism about their roles.
It would be unrealistic to hope for a change of heart from the chancellor on the continuation of the 1% cap on public sector pay, but he should stop his unfair comparisons with the private sector and inferences that public sector staff, including hard-working nurses, do not earn their pay. This unfair comparison only serves to impact negatively on morale and motivation.
Josie Irwin is head of employment relations at the Royal College of Nursing